Multiple Doctors Believe Rams WR Puka Nacua Is at Risk of Re-Injury

The Los Angeles Rams just got wide receiver Puka Nacua back last week after missing the previous two games with what the team described as a hip/groin injury.. Nacua looked good in his return with nine catches for 125 yards against the Philadelphia Eagles. However, according to multiple doctors, Nacua could be at risk for re-injury.

On Wednesday, Pro Football Talk’s Mike Florio noted that Nacua has been dealing with a pre-hernia. While it isn’t a hernia right now, it could develop into one.

“The question becomes whether the rest has allowed the weakness/strain in the affected area of the hip/groin to improve sufficiently to prevent a hernia from developing,” said Florio. “If it ever does, there’s only one way to fix it.”

The one way to fix it would be surgery, and the Rams will hope it doesn’t come to that point. A typical recovery from a hernia surgery would be 4-6 weeks and Nacua would almost certainly land on injured reserve if that were to be the case. After resting Nacua for the past two weeks, the Rams are banking on that helping the issue long-term.

However, there is some risk with Nacua, especially with his physical style of play. Toward the end of training camp, Nacua was held out due to a psoas injury in his groin. Following the Rams’ Week 1 loss to the 49ers, Nacua felt discomfort during the following week of practice and didn’t return until last week..

Why Doctors Are Concerned About Puka Nacua’s Injury

Despite the Rams erring on the side of caution with Nacua, some doctors seem to believe it’s only a matter of when, not if, Nacua re-aggravates the injury.

Dr. Jeff Mueller on Twitter noted that there is some re-injury risk.

“My guess with Puka is that this sling suffered enough trauma to require rehab but not to a full extent of requiring sports hernia surgery,” said Mueller. “In that scenario, their hope is that the traumatized tissue scars over/heals enough to where it doesn’t rip any further. However, this does place enough reinjury risk where if he twists sharply and it does rip the tissue more, it could push him into a situation where it causes a true sports hernia.”

Puka Nacua Q:

It’s some speculation on our part but we know for sure that Puka has dealt with Groin and Hip Flexor muscle injuries since August with a condition currently labeled as “pre-hernia”.

Sports Hernia injuries involve the groin, abdominal and hip flexor musculature.… https://t.co/vYhWttjNjS pic.twitter.com/r40i6k8EkJ
— Jeff Mueller, PT, DPT (@jmthrivept) October 7, 2026

Throughout the offseason, the Rams have erred on the side of caution with several of their star players, Nacua included. If they are able to avoid surgery and a longer absence, that’s obviously ideal.

Still, this is a similar approach that the Rams took with Myles Garrett. The Rams held out Garrett for much of training camp, hoping that the swelling in his knee would go down. Garrett’s knee didn’t respond as the team had hoped and he had one of the worst games of his career in Week 1 against the 49ers because he wasn’t able to feel like himself.Had Garrett simply gotten surgery in the offseason, the team may have been able to avoid that situation altogether.

Puka Nacua Remains at Risk of Re-Injury

It appears to be a similar situation here with Nacua. With the Rams being in the middle of the season, they obviously want to avoid the surgery if they can. However, they could be delaying the inevitable.

“This is a matter of when, not if. Best case scenario, he makes it the entire season and ends up having sports hernia repair surgery (likely by Dr. William Meyers) in the off-season,” said Dr. Jesse Morse. “Every time he lifts his leg, pushes his foot down to cut and get off the line, he is stressing this tissue. Every time he reaches out over his head for a ball that is higher than usual, this currently damaged tissue is going to be stressed further.”

Morse noted that if Nacua were to suffer a significant setback, the surgery would be moved up significantly and would take about six weeks to return.

Puka Nacua

In my opinion, this is matter of when, not if

Best case scenario, he makes it the entire season and ends up having sports hernia repair surgery (likely by Dr. William Meyers) in the off-season.

Every time he lifts his leg, pushes his foot down to cut and get off… https://t.co/C6oTmuokV8
— Jesse Morse, M.D. (@DrJesseMorse) October 5, 2026

Nacua looked good in his return, but his physical style of play will always leave him susceptible to injury. When Nacua spoke to the media last week, he said he felt good. Still, as Florio said, “Nacua has been dealing with the symptoms of the kind of weakness in the structures that can allow a hernia to form. It hasn’t yet, and that may simply be a matter of luck.”

For now, the Rams will hope that the two weeks of rest were enough time for Nacua’s injury to heal. His performance against the Eagles was certainly encouraging, but it doesn’t necessarily mean the issue is behind him. The Rams avoided the worst-case scenario, but the risk of a significant setback may not be going away anytime soon.

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